Last Resort
Last Resort is a fifth season episode of House which is scheduled to air in November 2008. HOUSE executive producer Katie Jacobs directs an all-new extended episode, guest-starring recent Emmy Award winner Željko Ivanek. A man (guest star Ivanek) willing to kill – or die – for a diagnosis takes House, Thirteen (Olivia Wilde) and several patients from the hospital waiting room hostage in Cuddy’s office. With one person shot, other patients needing medical attention, Thirteen being used as a guinea pig and the SWAT team closing in, House is determined to end the standoff the only way he knows how: by coming up with the right diagnosis. Recap A migraine patient is trying to get Thirteen to rush him through the clinic. Foreman comes in and asks Thirteen if she wants to participate in a Huntington's drug trial. She says she's not interested, and says she's not taking any treatment for her condition. Another patient comes into Cuddy's office and finds House. He tells him to get lost. However, a few minutes later, the patient comes in with a gun and hostages, mainly consisting of clinic patients but also including a nurse and Dr. Hadley (Thirteen) and demands that the best doctor in the hospital come and tell him what's wrong with him. House asks him, "What seems to be the problem?" The patient with the gun starts barricading himself in Cuddy's office. House asks him not to barricade the bathroom, pointing out that many of the hostages are sick patients and doing so would likely cause some problems, but the patient ignores him. The patient starts talking about how many doctors he's seen, how he can't breathe, how tired he is, his insomnia, and his heart palpitations. He shoves his medical records into House's hands. House examines the patient. He correctly guesses the patient's medical history without looking at it: all the tests are normal. The patient is having shortness of breath and pain when he inhales. House asks the hostages if they have a lighter. Thirteen moves to look in Cuddy's desk for one, but House tells her not to touch the desk. He manages to scrounge a lighter from one of the hostages to test if the patient can blow it out. He wheezes. House diagnoses pulmonary scleraderma. Cuddy calls the office. House asks for something to confirm the diagnosis. The patient doesn't trust a cop coming near the office and says that he wants Cuddy to deliver the drugs. House gets the drugs from Cuddy, but the patient won't let House inject him without injecting someone else first. Unfortunately, all the patients would suffer an adverse reaction given their own sicknesses. The patient tells House that the migraine-sufferer is not on painkillers, so House chooses him. The migraine-sufferer objects, saying that Thirteen should be the one injected because she is a doctor, however, he ends up getting the injection anyway. The test goes well and the patient (the gunman) agrees to be injected. However, right after the agreement, the migraine-sufferer keels over and the patient realizes that the drug is a sedative. The patient shoots one of the hostages in the leg to show House that he shouldn't screw with him. Thirteen treats the gunshot patient. The phone in the office rings, but the patient doesn't answer. The police arrive at the hospital. Taub, Kutner and Cameron discuss the situation, and all of a sudden get a call from House. He puts both of his teams back together. Chase doesn't want to participate, noting that the patient isn't the only sick person "in New Jersey with a pistol." Foreman starts a differential. House uses the office wall as a whiteboard as his team starts a differential diagnosis. House realizes the patient has a way out as he gives House his address. House arranges to transfer a blood sample. The patient hears police snipers outside and tells Thirteen opens the blinds, showing the snipers. He tells them to back off. House realizes that the patient hearing must have been extremely good to hear the snipers and thinks that it is a symptom. House thinks it might be intermittent palsy, but the test is painful and dangerous. The patient agrees to it although the treatment is safe and painless because he needs to know right away. The police are negotiating terms for the exchange. House tells the police not to be so rigid. Cuddy agrees to do the exchange although the police thinks she has an agenda. Cuddy gives House the drugs and recovers two hostages. The patient wants House to inject someone else, but the drug causes nerve and muscle damage. Thirteen agrees to be injected. House tells Thirteen how stupid she is being - the drug is bad for Huntington's patients. Thirteen collapses in pain. House is trying to figure out the patient and asks him why a diagnosis is so important. The patient reacts in pain to the injection as well. Taub and Kutner do the environmental scan. They notice that the patient must have known that he wasn't going back to his home, as he has laid out everything the doctors would need for them. Kuther notices that the patient has large unpaid medical bills and he and Taub get into a conversation about sick people being in debt because of hospital bills. Foreman and Cameron can't find any problem with the blood tests, ruling out everything except a heart problem and cancer. Thirteen notices a problem with his jugular vein. House checks his pulse - its up to 160. House starts a carotid artery massage to slow his heart. Thirteen wants to get a drug to slow down his heart, and the patient agrees to give her thirty seconds, but only after pointing the gun at young boy hostage so that Thirteen understands that if she doesn't come back, he will kill the boy. After running outside, Thirteen freezes when she sees police officers. Back in the room, House speculates that Thirteen won't come back. The nurse hostage disagrees since if Thirteen doesn't come back, the patient will shoot the boy. House criticizes her, implicitly claiming that no one thinks that others' lives are more important than their own. However, House is proven wrong: when it seems that Thirteen will not be coming back, the patient acts as if he's about to shoot the boy, but the nurse yells for the patient to shoot her instead. However, at the last second, she decides she does not want to die. Thirteen soon rushes back in, and no one is shot. The patient once again asks that someone else be injected with the drug first. However, the drug slows the heart rate, and slowing the heart rate of someone who already has a normal heart rate is dangerous. House objects to this, but Thirteen voluntarily injects herself and passes out with a dangerously low heart beat. House injects the patient and his heartbeat returns to normal. House notices that the patient is only sweating on one side of his face, indicating that it's probably lung cancer. Thirteen's heart rate continues to fall. House orders the nurse and the boy to help her up to raise her heart rate. House calls Wilson for a way to confirm a cancer diagnosis. House then tells the patient to spit on the floor. The patient coughs, showing that his mouth is dry. Wilson thinks it's a tumor. The only way to confirm is an X-ray. The patient wants to trade hostages for an X-ray. The patient bundles the hostages together around him and they start off towards radiology. House still wants to know why the patient is taking such steps. The patient says he just wants an answer. They get to radiology. House goes to get the computer monitor as the patient gets in the scanning machine, threatening to shoot if anyone moves. House thinks there must be a deeper reason, but the patient denies it. After the CT Scan, House tells the patient that if he wants the answer, he'll have to give him the gun, first. Then he rights something down on a notepad and hands the notepad to one of the hostages. Then he turns about the results of the scan and asks Thirteen what she says. She replies that it's a starburst caused by the gun he was holding during the scan, obscuring the CT results. The hostage turns the notepad around and it says "starburst" on it. This proves that Thirteen wasn't just making up what she was saying as a way to get the gun from the patient. The patient finally gives up the gun the last hostages, except for House, Thirteen, and the boy from earlier, run out. House asks the boy why he stayed. The boy says he's curious and that it was probably safe now that the patient has rescinded his gun. Unfortunately, even after the gun is removed from the scanner, the scan can't find a tumor. House admits that he's stumped. The patient resigns himself to House's failure. However, House gives him back the gun, surprising everybody. House tells the police that the patient overpowered him. Thirteen starts screaming at House for always having to know the answer and being so afraid to be wrong that he'd even risk the lives of others to figure out the answer. House yells back at Thirteen that he's only arrogant, that's she's the coward for trying to shorten her own life. House calls Wilson and the team. He wants to keep up the diagnosis, but Foreman agrees with Chase and quits too. The rest of the team starts a differential. The patient shows a new symptom - partial deafness in his right ear. House thinks it might be Cushing's syndrome. The patient trades the boy for drugs. The patient still wants the drug to be used on Thirteen first. Thirteen takes the needle from House and injects herself. The patient finds out Thirteen has no more than ten years to live. House injects the patient. Thirteen starts having an increased heart rate and fever. House realizes her kidneys are shutting down. House realizes Thirteen needs more medical care. He's wondering why the patient's kidney's are fine. House slaps the patient and realizes that he has calcium deficiency. Cameron realizes that the protein pump inhibitors he takes as an antacid are protecting his kidneys. House realizes it must be a disease with a very long incubation period. Cameron suggests meliadosis, but it only affects people who have been to the tropics, and the patient's history doesn't indicate that. However, the patient admits he's been to Florida, which he didn't think was in "the tropics". House chastises the previous doctors who left this out of the history. House orders the drug to treat it, but the police are tired of negotiating with the patient. The patient then says that he'll trade House for the drugs. House realizes that he's going to give Thirteen the drug once again and tells the patient that he'll inject the drug in himself because more drugs would kill Thirteen. The patient doesn't care, noting that since Thirteen has taken everything that he's taken, any bad reactions she has to it would more accurately reflect what would happen to him. Thirteen tells House that she'll either die from the drug or the patient will shoot her, so she'll die either way. House leaves the room and we see the patient telling Thirteen to inject herself with the drug. Unlike the previous times where she readily injected herself, this time she is scared and admits that she doesn't want to die. We also see the police setting something up outside of the room. The patient points his gun at her, threatening her. Thirteen puts the needle closer and closer to her arm, but keeps crying that she doesn't want to die. She tells the patient, "Sometimes you just have to trust people." The patient isn't buying it. After more moments of her moving the needle closer to her arm, she exclaims that she doesn't want to die once more. The patient grows frustrated and slams the gun down and takes the drug, injecting himself, since Thirteen is obviously refusing to do so. Right at that moment, the side of the room blows up (the police were setting up a bomb). The patient and Thirteen are both knocked to the floor. The police rush in. House comes back into the room and goes to Thirteen. He asks Thirteen why she's still alive. Instead of telling House that she was refusing to take the drug, she lies tells him that he didn't make her take it. The patient is seen walking out of the hospital with the SWAT guards. House puts his hand on his chest, indicating that the patient exhale to see if the treatment worked. The patient exhales normally, and smiles at House. House nods and the patient, with the guards, exits the hospital. Cuddy walks into her office and sees the damage that was earlier done at the beginning of the episode. The screen pans over the writing on the wall House did to make up for the lack of a whiteboard, the bloodstains from the shot patient, and fallen furniture. House walks in and tells Cuddy that his diagnosis was confirmed. She gets mad at him for focusing on the diagnosis instead of the danger the hospital was just in. She then suggests that she would have handled the situation better if he weren't in the room with the patient. House says that Cuddy thinks that their "non-relationship" caused her to screw up, remarking that there is only one change that they can make from a "non-relationship." Cuddy then asks if House wants a relationship. House says, "God no," and says that he was just trying to follow her logic. House walks away and she sits down at her desk and opens the drawer, which falls out as a result. (House was playing with it at the beginning of the episode). Major Events * House, Thirteen and several other people are taken hostage by a sick patient demanding treatment at gunpoint. * Thirteen is forced to become a guinea pig for whatever drugs the patient receives. * As a result of the injections, Thirteen's health rapidly deteriorates. * Cuddy soon reveals that the patient is in jail with no chance of ever getting parole.